Medicare Now Covers Glaucoma Detection Eye Exam

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New Coverage to Benefit At-Risk Populations

01/22/02

Medicare now covers an annual dilated eye examination for all people at high risk for glaucoma. This important new preventive benefit will safeguard the vision of millions of Americans enrolled in the Medicare program.

This new coverage, effective January 1, 2002, is consistent with recommendations from the National Eye Institute, one of the Federal government’s National Institutes of Health, as well as from eye care professional organizations and consumer groups.

Glaucoma, a leading cause of blindness, affects about three million Americans-half of whom don’t know they have this eye disease.

The new benefit defines high risk Medicare beneficiaries as those with diabetes; those with a family history of glaucoma; and African Americans aged 50 and older. Glaucoma is five times more likely to occur in African Americans than in whites and about four times more likely to cause blindness in African Americans than in whites. “Preventive benefits, such as this new glaucoma coverage, help keep people enrolled in Medicare healthy and improve their quality of life,” said HHS Secretary Tommy G. Thompson. “An eye exam now can prevent serious problems later, even blindness. It is important that we make taking care of our eyes a part of our overall health maintenance program.”

“Glaucoma, and the risk of vision loss, remains unrecognized for millions of Americans,” said Paul A. Sieving, M.D., Ph.D., director of the National Eye Institute. “The expanded Medicare coverage will help people keep their vision, especially those at high risk for eye disease. “Once vision is lost from glaucoma, it cannot be restored—the damage is irreversible,” said Dr. Sieving. “Studies have shown that the early detection and treatment of glaucoma, before it causes major vision loss, is the best way to control the disease.”

The “air puff” test, which measures eye pressure, is one part of a glaucoma examination but this test by itself cannot detect glaucoma. Glaucoma is found most often during an eye examination through dilated pupils, which means drops are put into the eyes to enlarge the pupils. The eye care professional then can see more of the inside of the eye to check for signs of glaucoma.

The National Eye Institute (NEI) is part of the National Institutes of Health (NIH). NEI conducts and supports research that leads to sight-saving treatments and plays a key role in reducing visual impairment and blindness. The NIH is an agency of the U.S. Department of Health and Human Services.

The Centers for Medicare & Medicaid Services (CMS) is a Federal agency within the U.S. Department of Health and Human Services. CMS runs the Medicare and Medicaid programs - two national health care programs that benefit about 75 million Americans.

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